EXTRAMEDULLARY HEMATOPOIESIS MANIFESTING AS A SYMPTOMATIC PLEURAL EFFUSION

The occurrence of extramedullary hematopoiesis in the pleura is rare and is usually asymptomatic. It is generally diagnosed on postmortem examination, Herein we describe a 61-year-old woman with agnogenic myeloid metaplasia who sought medical assessment because of progressive dyspnea, Thoracentesis yielded sanguineous fluid with 10% myeloblasts. A Tc-99m bone marrow scan demonstrated increased tracer activity throughout both lungs, an outcome consistent with extramedullary hematopoiesis. Fine-needle aspiration and video-assisted thoracoscopy were considered but deferred because of the potential risk of profuse bleeding, Treatment with low-dose external beam irradiation to the left posterior pleura was successful, To date, no hemothorax has recurred.